What is kidney cancer?

Kidney cancer is a type of cancer that grows in the cells of the kidneys.

Kidney cancers usually grow as a solid tumour (lump) in one kidney. Sometimes it's possible to have one or more tumours in both kidneys. They start small but grow larger, eventually spreading to other parts of the body.

The cancer usually grows in the part of the kidney that filters blood. These tumours can be aggressive and can grow quickly. Sometimes the cancer will grow in the lining of the kidney or ureter (the tube that takes urine from the kidney to the bladder).

Kidney cancers that are found early can usually be cured.

What are the different types of kidney cancer?

Different types of kidney cancer are named after the type of cell where the cancer develops:

• The most common type is called renal cell carcinoma (or RCC). This type starts in the cells that line the tubules, which are part of the kidney's filtering system.
• Another type is called urothelial carcinoma (or transitional cell carcinoma). This cancer grows in the part of the kidney where urine collects before it passes into the bladder via the ureters.
• Wilms tumour (also called nephroblastoma) is a rare type of kidney cancer that mainly affects children.

What are the symptoms of kidney cancer?

Often there are no symptoms of kidney cancer in the early stages.

If you do have symptoms, they may include:

• blood in the urine
• a change in the colour of your urine to dark, rusty or brown
• a lump in your abdomen (tummy) or on your side
• pain in your side or lower back that doesn't go away
• unexplained weight loss
• fatigue that doesn't pass with rest
• fever

All of these symptoms could be due to something other than kidney cancer. If you are worried, see your doctor.

What causes kidney cancer?

Doctors don't know the exact cause of kidney cancer.

Kidney cancer is more common in males than in females. Factors that increase your risk of kidney cancer include:

• smoking
• living with overweight or obesity
• having high blood pressure
• having severe kidney disease
• having a close family member who had kidney cancer
• being exposed to certain chemicals
• some genetic conditions

When should I see my doctor?

See your doctor if you notice blood in your urine, a change in urine colour, or pain or swelling in your side or abdomen that doesn't go away.

Also seek medical advice if you experience unexplained weight loss, tiredness, or fever lasting a few days.

People who smoke or live with risk factors such as obesity, high blood pressure or a family history of kidney cancer should discuss regular check-ups with their doctor.

Finding kidney cancer early improves treatment outcomes.

How is kidney cancer diagnosed?

If your doctor suspects kidney cancer, they will refer you for blood and urine tests. Imaging tests such as CT, MRI, ultrasound or x-ray can check the kidneys and see if the cancer has spread to any other part of your body.

You might also have a biopsy, where a small sample of tissue is removed and examined in a laboratory.

If you have kidney cancer, your doctor will refer you to a specialist for treatment.

How is kidney cancer treated?

The treatment your doctor suggests will depend on the type of kidney cancer you have, where it is, and how far it has spread (known as its stage).

If the cancer is found early, the main treatment is surgery to remove the tumour or affected kidney. Other ways to treat the cancer include radiofrequency ablation (which uses high energy radio waves to heat the tumour) and radiation therapy (which uses radiation to kill the cancer).

Sometimes, your specialist might suggest watching and waiting instead of treating at first. They will check the area closely and only treat it if it starts to grow. This is known as 'active surveillance'.

If the cancer is more advanced and has spread, a range of treatments can help control the cancer and manage your symptoms. These may include medicines that target the cancer cells (targeted therapy), radiotherapy or medicine to stimulate your own immune system to fight the cancer (immunotherapy). Standard chemotherapy is rarely used for kidney cancer.

Living with kidney cancer

You can live a healthy life with just one kidney. If you have had a kidney removed because of cancer, it's important to look after your remaining kidney. Reducing your risk of conditions that can damage it, such as high blood pressure, heart problems and diabetes, will help protect your kidney. You can help by:

• avoiding or quitting smoking
• eating a healthy diet
• staying physically active
• limiting your alcohol intake

If your kidney function is low after cancer treatment, you may need regular dialysis to clean your blood. This often takes place in hospital.

After cancer treatment, it's natural to worry that the cancer might come back. If these feelings are hard to cope with, consider talking to your doctor, a counsellor or other people affected by cancer.

What are the complications of kidney cancer?

Kidney cancer can lead to several complications depending on its stage, growth and treatment. Some complications are caused by the tumour itself, while others result from the treatment.

Possible complications include:

• blood in your urine (haematuria) or pain in your back or side if the tumour grows into nearby tissues or blood vessels
• blockage of the urinary tract, which may cause swelling of the kidney (hydronephrosis) or infection
• low kidney function, or rarely kidney failure — after surgery or from loss of kidney tissue due to the cancer
• spread (metastasis) to other parts of the body, most often the lungs, bones, liver or brain — these may cause other symptoms such as shortness of breath, bone pain or swelling
• blood clots (thrombosis) due to changes in blood clotting factors caused by the tumour
• systemic effects such as weight loss, fatigue or anaemia
• fever — caused by tumour related inflammation

Treatment related complications

Treatment related complications may include:

• after surgery: pain, infection, bleeding, or long-term kidney impairment if a kidney is removed
• from targeted therapies: fatigue, high blood pressure, diarrhoea, or hand-foot skin reactions
• from immunotherapy: flu-like symptoms, skin rash, thyroid problems, or inflammation of the lungs, liver, or bowel
• from radiotherapy: fatigue, skin irritation, nausea, diarrhoea, and, rarely, damage to nearby organs such as the bowel or remaining kidney tissue

While most side effects can be managed, regular follow-up with your care team helps detect and treat complications early.

Can kidney cancer be prevented?

There is no way to completely prevent kidney cancer, but you can take steps to reduce your risk:

• avoid smoking: cigarette smoking is one of the strongest risk factors for kidney cancer
• maintain a healthy weight: overweight and obesity increase risk of kidney cancer, so ask your doctor for help if you'd like to lose weight
• manage your blood pressure: high blood pressure is linked to kidney cancer, so managing it with lifestyle changes or medicines may reduce your risk
• limit your exposure to harmful chemicals: certain workplace chemicals, such as some industrial solvents, can increase risk
• know your family history: people with a family history of kidney cancer or inherited conditions should discuss screening or monitoring with their doctor

These steps cannot guarantee prevention, but they can lower the chances of developing kidney cancer.

Resources and support

For more information and support, try these resources:

• Kidney Health Australia has information about supporting yourself or someone you care for with kidney cancer.
• Cancer Council Australia provides services and support for people affected by cancer — call 13 11 20.
• Beyond Blue provides support for people with depression and anxiety — call 1300 22 4636.
• General information about cancer is available online in many community languages.
• Read more about cancer for Aboriginal and/or Torres Strait Islander people s.

Information for Aboriginal and/or Torres Strait Islander peoples

• Read all about cancer for Aboriginal and/or Torres Strait Islander people.
• Watch the video Our Mob and Cancer.

Languages other than English

• Cancer Australia has a range of resources about cancer that have been translated into other languages.
• General information from New South Wales Health about cancer is available online in many community languages.